Sustainable Financing and HIV, Malaria, TB Control

1Ambassador on HIV/AIDS and Transmissible Diseases; Director, National Agency for Research on AIDS, Paris, France

Key issues:

The issue of sustainability of funding is becoming critical as we realize the central role of funding the fight against pandemics for development and as we move from an emergency mode of response to building sustainability. Thus, the health sector that was originally seen as a non-profitable source of expenditure, is now considered as a factor and a necessary investment for development. New models of funding and of governance have recently emerged, e.g. GAVI for immunization and the Global Fund against HIV/AIDS, TB and Malaria (GFATM). After four years, the GFATM faces a number of challenges in its business model: Should it fund projects or adopt a more programmatic approach? Should investments in health remain vertical or should they primarily focus on strengthening health systems? How to reconcile the tension between emergency and sustainability?

Conclusion (max 400 words):

An increase in official Development Aid (ODA) is clearly part of the answer. Yet, despite a commitment from Europe to reach 0.56% of GDP for ODA by 2010, and 0.7% by 2012-2015, the growth in the ODA will be both insufficient and unpredictable in the next few years. To complement ODA, an active search for alternative, innovative mechanisms for funding, has been initiated, following the call for such new financing sources by President Lula and a group of Heads of States in 2004. Among these are new taxes on activities linked to globalization, taxes on financial transactions, and private initiatives. In the last year, two such innovative sources of funding have emerged and will be discussed during this presentation: (1) an airline ticket levy that is being implemented from year 2006 by France, Brazil, Chile and Norway; (2) the red initiative that will allow new funding for the GFATM from a fixed percentage of the product of sales by participating private companies. The sustainable resources from both initiatives will be devoted to HIV, malaria and TB control.